Pediatric Asthma Care Coordination in Underserved Communities: A Quasiexperimental Study.

Abstract:

OBJECTIVES:To assess the effect of care coordination on asthma outcomes among children in underserved urban communities. METHODS:We enrolled children, most of whom had very poorly or not well-controlled asthma, in medical-social care coordination programs in Los Angeles, California; Chicago, Illinois; Philadelphia, Pennsylvania; and San Juan, Puerto Rico in 2011 to 2014. Participants (n = 805; mean age = 7 years) were 60% male, 50% African American, and 42% Latino. We assessed asthma symptoms and health care utilization via parent interview at baseline and 12 months. To prevent overestimation of intervention effects, we constructed a comparison group using bootstrap resampling of matched control cases from previous pediatric asthma trials. RESULTS:At follow-up, intervention participants had 2.2 fewer symptom days per month (SD = 0.3; P < .01) and 1.9 fewer symptom nights per month (SD = 0.35; P < .01) than did the comparison group. The relative risk in the past year associated with the intervention was 0.63 (95% confidence interval [CI] = 0.45, 0.89) for an emergency department visit and 0.69 (95% CI = 0.47, 1.01) for hospitalization. CONCLUSIONS:Care coordination may improve pediatric asthma symptom control and reduce emergency department visits. POLICY IMPLICATIONS:Expanding third-party reimbursement for care coordination services may help reduce pediatric asthma disparities.

journal_name

Am J Public Health

authors

Janevic MR,Stoll S,Wilkin M,Song PX,Baptist A,Lara M,Ramos-Valencia G,Bryant-Stephens T,Persky V,Uyeda K,Lesch JK,Wang W,Malveaux FJ

doi

10.2105/AJPH.2016.303373

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

2012-2018

issue

11

eissn

0090-0036

issn

1541-0048

journal_volume

106

pub_type

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